Gaudette Étienne, Goldman Dana P, Messali Andrew, Sood Neeraj
Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, 635 Downey Way, Suite 210, Los Angeles, California, 90089-3333, USA,
Pharmacoeconomics. 2015 Jul;33(7):723-34. doi: 10.1007/s40273-014-0234-y.
Obesity impacts both individual health and, given its high prevalence, total health care spending. However, as medical technology evolves, health outcomes for a number of obesity-related illnesses improve. This article examines whether medical innovation can mitigate the adverse health and spending associated with obesity, using statins as a case study. Because of the relationship between obesity and hypercholesterolaemia, statins play an important role in the medical management of obese individuals and the prevention of costly obesity-related sequelae.
Using well-recognized estimates of the health impact of statins and the Future Elderly Model (FEM)-an established dynamic microsimulation model of the health of Americans aged over 50 years-we estimate the changes in life expectancy, functional status and health care costs of obesity due to the introduction and widespread use of statins.
Life expectancy gains of statins are estimated to be 5-6 % greater for obese individuals than for healthy-weight individuals, but most of these additional gains are associated with some level of disability. Considering both medical spending and the value of quality-adjusted life-years, statins do not significantly alter the costs of class 1 and 2 obesity (body mass index [BMI] ≥30 and ≥35 kg/m(2), respectively) and they increase the costs of class 3 obesity (BMI ≥40 kg/m(2)) by 1.2 %.
Although statins are very effective medications for lowering the risk of obesity-associated illnesses, they do not significantly reduce the costs of obesity.
肥胖不仅影响个人健康,而且鉴于其高患病率,还会影响总体医疗保健支出。然而,随着医学技术的发展,许多与肥胖相关疾病的健康结局有所改善。本文以他汀类药物为例,研究医学创新是否能够减轻与肥胖相关的不良健康影响和支出。由于肥胖与高胆固醇血症之间的关系,他汀类药物在肥胖个体的医疗管理以及预防代价高昂的肥胖相关后遗症方面发挥着重要作用。
利用公认的他汀类药物对健康影响的评估以及未来老年人模型(FEM)——一个已建立的50岁以上美国人健康状况的动态微观模拟模型——我们估计了由于他汀类药物的引入和广泛使用,肥胖人群在预期寿命、功能状态和医疗保健成本方面的变化。
据估计,他汀类药物使肥胖个体的预期寿命增加幅度比健康体重个体高5% - 6%,但这些额外增加的预期寿命大多与某种程度的残疾有关。综合考虑医疗支出和质量调整生命年的价值,他汀类药物并未显著改变1级和2级肥胖(体重指数[BMI]分别≥30和≥35kg/m²)的成本,而使3级肥胖(BMI≥40kg/m²)的成本增加了1.2%。
尽管他汀类药物是降低肥胖相关疾病风险的非常有效的药物,但它们并未显著降低肥胖的成本。